Effect of a single or multiple courses of antenatal corticosteroids on neonatal respiratory distress syndrome in pregnancies complicated by hypertension = Effect of a single or multiple courses of antenatal corticosteroids on neonatal respiratory distress syndrome in pregnancies complicated by hypertension

다국어 초록 (Multilingual Abstract)

Objective: The purpose of the current study was to determine the effect of antenatal corticosteroid (ACS) therapy, single or multiple courses, on the incidence of neonatal respiratory distress syndrome (RDS) in pregnancies complicated by hypertension. Methods: We retrospectively evaluated the pregnancy and neonatal outcomes of 119 gravidas with hypertensive disorders who were admitted at 24~34 weeks gestation and delivered before 36 weeks gestation. Hypertensive disorders of pregnancy included gestational hypertension (n=1), mild pre-eclampsia (n=6), severe pre-eclampsia (n=99), superimposed pre-eclampsia on chronic hypertension (n=11), eclampsia (n=1), and chronic hypertension (n=1). The subjects were categorized into three groups according to ACS treatment: (1) non-user group (n=52), (2) single course group (n=56), and (3) multiple course group (n=11). Univariate and multiple logistic regression analyses were used for the incidenc of RDS. Results: Based on the univariate analysis, the incidence of RDS was not significantly different between the three groups (40.4% vs. 39.3% vs. 36.4%, respectively; P=0.969). However, after adjusting confounding factors, including gestational age at delivery, admission-to-delivery interval, delivery mode, and birth weight, treatment with ACS was associated with a significant reduction in the incidence of RDS (OR, 0.272; 95% CI, 0.079~0.937; P=0.039). In addition, multiple courses of ACS were associated with a further reduction in the incidence of RDS (OR, 0.046; 95% CI, 0.004~0.520; P=0.013). Conclusion: In pregnancies complicated by hypertensive disorders, treatment with ACS was associated with a significantly decreased risk of RDS, and the risk was further decreased with multiple courses of ACS.